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if(window.location.pathname.indexOf(“647856”) != -1) {console.log(“hedva connatix”);document.getElementsByClassName(“divConnatix”)[0].style.display =”none”;}Because vaccination was also closely linked to the Poor Law legislation that forced workers and their families into the brutalizing regime of the workhouse, its new compulsory status seemed an attempt to extend this same punitive attention to the working classes.These protests were not the result of irrational conspiracy theories. Whatever good vaccination might have done in controlling the ravages of smallpox, which indeed ran wild through the crowded, inadequate dwellings of the laboring poor, fear that vaccination might lead to further marginalization was strong and, given the context, reasonable. In choosing between disease or subjugation, the working poor of the Victorian era chose what they perceived to be – and might well have been – the lesser of two evils.Though these events are now a part of history, they are not behind us. Their legacies are passed from generation to generation, sometimes explicitly in the collective memory of a population, and other times more quietly in the form of persistent disenfranchisement. Indeed, the discouraging COVID-19 incidence and mortality rates we have witnessed among minority ethnic groups point toward the same systemic racism that events like Tuskegee only more explicitly conveyed.These seeds of distrust have been planted around the globe. The CIA’s campaign to find Osama bin Laden involved a fake hepatitis B vaccination project, that understandably eroded public trust in global health programs in Pakistan.Pharmaceutical companies habitually try out their wares on nations in the global south before marketing them to their richer, whiter neighbours in the north. That rumours fly as a result cannot be pinned on rabble-rousing conspiracy theorists. Hesitancy in these contexts is at the very least understandable. Simply put, there is a global shortage of trust. And trust is what we sorely need for vaccination uptake and success.Given this, the more surprising fact may well be that the vast majority of people are willing to trust that their government will do right by its citizens. This tells us something encouraging about the faith people now have in medicine and scientific research. But this should not stop us from having important conversations about why some people might pause in the face of a new vaccine.In the wake of this good vaccine news, it may seem a small matter that we relegate vaccine hesitators to the scrap heap of conspiracy theorists. But this rhetoric matters: it obscures the far more nuanced set of reasons people hesitate, and it prevents us from thinking carefully about why we trust and why others might not.This article was originally published in The Conversation.